Regional Anesthesia and Acute Pain ManagementRegional Anesthesia and Acute Pain ManagementРегионарная анестезия и лечение острой боли1993-65082687-1394Eco-Vector65410610.17816/RA654106REJNQLReviewsНаучные обзорыReview ArticleNefopam as an alternative to nonsteroidal anti-inflammatory drugs in perioperative pain management: a narrative reviewНефопам как альтернатива нестероидным противовоспалительным препаратам в схемах периоперационного обезболивания: описательный обзор литературыhttps://orcid.org/0000-0002-3453-86991277-9220OvechkinАlexei М.ОвечкинАлексей Михайлович
Russian Federation

MD, Dr. Sci. (Medicine), Department Professor

д-р мед. наук, профессор кафедры

ovechkin_alexei@mail.ruhttps://orcid.org/0000-0003-0623-4927572040155972048-9705PolitovMikhail E.ПолитовМихаил Евгеньевич
Russian Federation

MD, Cand. Sci. (Medicine), Associate Professor

канд. мед. наук, доцент

politov_m_e@staff.sechenov.ruhttps://orcid.org/0009-0006-1561-1033PetrovskiiVladimir F.ПетровскийВладимир Фёдорович
Russian Federation

student

студент

4sr15@mail.ruhttps://orcid.org/0009-0001-2897-41443647-7561SheinaMaria A.ШеинаМария Александровна
Russian Federation

MD, Department Assistant

ассистент кафедры

sheina_m_a@staff.sechenov.ruhttps://orcid.org/0000-0001-6805-97448933-8819SokologorskiySergey V.СокологорскийСергей Васильевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

docsvs@mail.ruSechenov First Moscow State Medical UniversityПервый Московский государственный медицинский университет им. И.М. Сеченова150420252205202519118280902202509032025Copyright ©; 2025, Eco-VectorCopyright ©; 2025, Эко-Вектор2025Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://rjraap.com/1993-6508/article/view/654106

Nonsteroidal anti-inflammatory drugs (NSAIDs) constitute the foundation of contemporary perioperative pain management regimens. However, their use is often limited by a broad range of serious adverse effects and contraindications. This review, based on an analysis of the scientific sources, aims to evaluate the analgesic efficacy and safety of nefopam, a centrally acting non-opioid analgesic, as an alternative to NSAIDs in perioperative pain management regimens. A search of medical databases, including PubMed (MEDLINE), the Cochrane Library, and eLibrary (RSCI), was conducted from July 1 to December 30, 2024. Nefopam has demonstrated consistent analgesic and opioid-sparing effects in laparoscopic surgery, spinal surgery, cardiac surgery, and transplantation, as well as in patients in intensive care units. Additional beneficial effects include prevention and treatment of postoperative shivering and reduction of discomfort and pain associated with urinary catheterization. The most commonly reported adverse effects of nefopam include excessive sweating, tachycardia following intravenous administration, and dry mouth. Overall, nefopam appears to have a more favorable safety profile compared with NSAIDs.

Нестероидные противовоспалительные средства (НПВС) служат основой современных схем периоперационного обезболивания. Однако их применение ограничено широким спектром серьёзных нежелательных реакций и противопоказаний. Целью нашего обзора литературы стала основанная на анализе литературы оценка анальгетического эффекта и безопасности применения неопиоидного анальгетика центрального действия нефопама в схемах периоперационного обезболивания в качестве альтернативы препаратам группы НПВС. Поиск источников проводили в электронных медицинских базах данных и библиотеках PubMed (MEDLINE), Cochrane Library, eLibrary (РИНЦ). Поисковые запросы были сформированы за период с 01.07.2024 по 30.12.24. Установлен отчётливый анальгетический и опиоидсберегающий эффект нефопама в лапароскопической хирургии, хирургии позвоночника, кардиохирургии, трансплантологии и у пациентов отделений реанимации и интенсивной терапии. Дополнительные позитивные эффекты нефопама включают профилактику и купирование послеоперационного озноба, а также устранение дискомфорта и болевых ощущений при катетеризации мочевого пузыря. Основные нежелательные реакции применения нефопама включают избыточную потливость пациентов, тахикардию при внутривенном введении, сухость во рту. Таким образом, профиль безопасности этого препарата можно считать предпочтительным в сравнении с таковым лекарственных средств группы НПВС.

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